Search

We reviewed ninety-two patients who were more than forty years old when they underwent arthroscopic meniscectomy. Their mean age was 56.7 years (range: 40 to 80 years). These patients were evaluated using the Japanese Orthopaedic Association Score for meniscus injuries. There was no correlation between age, grade of osteoarthritis on preoperative radiograghs, grade of articular cartilage degeneration, and surgical results. Arthroscopic meniscectomy was proven to be an effective procedure for patients over the age of 40.

We investigated 4 cases of femoral fractures after bipolar hemiarthroplasty and total hip arthroplasty. All 5 cases were female ranging in age from 55 to 90 years (average, 75 years). According to Johansson's classification, 2 cases were type 2; and the others were type 3. Peroprosthetic fractures in 4 femurs were fixed using a plate with cables, long stem with CCG band, supracondylar plate with cables, and Mennen plate with kuntcher nail. After operation, X-ray revealed that all casess resulted in union. The Postoperative Japanese Orthopedic Association score ranged from 46 to 65 points (average: 55.3 points).Open reducation can be a good choice for the treatment of periprosthetic fractures.

The purpose of this study was to investigate the relationship between the restoration of the spinal cord just after decompression surgery and preoperative MRI findings. 13 patients underwent posterior decompression surgery at the cervical and thoracic level. The frontal diameter of the spinal cord was measured using pre-operative MRI and intra-operative ultrasonography. The restoration rate was calculated according to Kataoka's method from the pre and intra-operative diameters. Clinical results were also recorded using the Japanese Orthopedic Association score. Correlation between the restoration rate, clinical results, and MRI findings was evaluated. Significant correlation was observed between the restoration rate and clinical results (R=0.61). Also the spinal cord which indicated high signal intensity on the T2 WI preoperative MRI had a tendency to show a low restoration rate. These results suggest that the combination of the low restoration rate and high signal intensity of the spinal cord indicates severe spinal cord damage.

40 primary uncemeneted total knee arthroplasties (MG II) were performed in 32 patients with osteoarthritis. The average age was 73.0 years at the time of surgery. The follow-up period was an average of 5.6 years (range; 5 to 6.6 years). Clinical evaluations based on the Japanese Orthopedic Association score indicated significant improvements from preoperative to the most recent follow-upexamination. There was no evidence of rentogenographic failure in the femoraland tibial component. None of the knees required revision surgery. The flexion angle at the last follow-up correlated well with the last clinical score, especially in the ability of stairs. The clinical score of patients with flexionangle over 110° was significantly better than that under 110°. These mid-term results of uncemented MG II TKAs proved satisfactory in osteoarthritis. However, a longer follow-up period is necessary for problems related to the patellarcomponent even in MG II TKAs, because mal-alignment of the patella-femoral jointhas been observed in 4 knees.

Eighty-two patients underwent discectomy for herniated nucleus pulposus between 1985 and 1989. Of these, 49 patients were diagnosed having a ruptured disc herniation. All ruptured disc herniations were removed from the posterior approach without fusion. The average improvement rate by the Japanese Orthopedic Association Score was 79.7%. We consider the surgical treatment should be done as early as possible after clinical and imaging assessment of ruptured disc herniation. This attributes a good result.

Lumbar disc herniation in aged patients is relatively rare. Eighteen cases of lumbar disc herniation over 60 years of age treated by Love's operation were evaluated.Pre-operative clinical findings were relatively severe. All patients complained of lumbago and pain of the lower extremity. The average improvement rate by the Japanese Orthopaedic Association Score was 62 percent.